| NPI | 1053199968 |
|---|---|
| Former Legal Business Name | EPIC DENTAL CARE PLLC |
| Former Legal Business Name | RADIANCE DENTAL PLLC |
| Entity Type | Organization |
| Authorized Contact | KRISTINA VADIMOVNA ROGOZHKINA President 918-260-1389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2024-04-17 |